Day 1 — Tuesday, April 30

Welcome 1:00 - 1:05 pm

Welcome from CommPartners Virtual Team 

Welcome and opening remarks to kick of the  SAMHSA NCTSN Virtual ANC 2019! 

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SAMHSA Leadership Welcome 1:05 - 1:10 pm

Presenter: Anita Everett, MD

Welcoming remarks from the SAMHSA Center for Mental Health Services (CMHS) Director

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NCTSN Leadership Welcome 1:10 - 1:15 pm

Presenters: Robert Pynoos, MD; John Fairbank, PhD

Welcoming remarks from the National Center for Child Traumatic Stress Network (NCTSN) Co-Directors

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Workshop #11:15 - 2:15 pm

A Tale of Two Interventions: Considerations in Culturally Responsive Adaptation

Presenters: Abigail Gewirtz; Alisa B. Miller, PhD; Rubén Parra-Cardona, PhD

Session Description:


Intervention adaptation is an ethical and promising approach to bringing evidence-based practices to under-served communities. There is a dearth of evidence-based and evidence-informed parenting programs that support unique experiences of children and families who have experienced the effects of war including displacement, traumatic stress, resettlement, acculturation, and isolation as well as deployment overseas.  

Parents are their children’s best teachers and evidence-based parenting prevention/interventions can create lasting improvements in children who have been traumatized. Two highly relevant populations in need of quality services are military families and refugees/immigrants new to the United States. Kumpher and colleagues (2016) suggest that adapting evidence-based interventions increases family engagement by 40%.  In order to raise the standard of care for these groups, treatment developers and mental health providers must seek out evidence-based and informed interventions that not only engage families from a variety of cultural backgrounds and communities but are also viewed as relevant and meaningful.  

This workshop aims to provide general principles for adapting evidence-based interventions, and specifically parenting programs, for different cultural groups. Key principles that will increase cultural responsiveness and ultimately family engagement will be highlighted.  We will focus on families impacted by the experience of war/displacement, specifically refugee/immigrant families and military families who have been impacted by deployment overseas.  Two case studies will be employed to illustrate the principles and demonstrate the importance of fit and fidelity when adapting an existing program, Parent management training—the Oregon model, to be responsive to cultural communities.

Dr Alisa Miller, at the Refugee Trauma and Resilience Center, Boston Hospital will provide an overview of general principles to consider when adapting evidence based programs to be culturally responsive, relevant and meaningful.

Dr. Abi Gewirtz, at the Center for Resilient Families, University of Minnesota, will present the first case study of her work adapting an evidence-based parenting prevention intervention to military families whose children have been traumatized by their parent’s military deployment overseas.

Dr. Jose Ruben Parra-Cardona, at the University of Texas at Austin, will present the second case study on his work adapting a parenting prevention intervention to Latinx parents.   

Presenters' Information:
Dr. Abigail Gewirtz’s
research interests are in trauma, resilience, parenting, and promoting children’s healthy development, with two distinct research foci: (1) the impact of exposure to highly stressful and traumatic events (e.g., homelessness, violence, war) on parenting and child functioning and (2) the development, implementation and evaluation of evidenced-based, family-focused interventions in community settings. Her research team is currently working on two major projects: After Deployment, Adaptive Parenting Tools (ADAPT) and Ambit Network. ADAPT, funded by the National Institute of Drug Abuse, is a randomized controlled trial of a parenting intervention aimed at strengthening parenting, child, and couple well-being among veterans following their combat deployment to Iraq and Afghanistan (Gewirtz, et al., 2011). Ambit Network, funded by the Substance Abuse and Mental Health Services Administration, aims to increase access to quality care for traumatized children across Minnesota and the Upper Midwest. Dr. Gewirtz is well published, the recipient of several grant and career awards.

Alisa B. Miller, PhD, is a Research Associate at Boston Children’s Hospital Refugee Trauma and Resilience Center (RTRC Cat II of the NCTSN) and a Licensed Clinical Psychologist in Massachusetts. Dr. Miller is an Assistant in Psychology in the Department of Psychiatry at Boston Children’s Hospital and an Instructor in Psychology at Harvard Medical School. At the RTRC, she conducts community-based participatory research and assists in intervention development. She has been an integral part of the team developing Trauma Systems Therapy for Refugees (TST-R) and provides training and consultation to various agencies across the United States implementing this model. Her interests focus on how trauma, migration, and culture shape development and impact life trajectories. Dr. Miller is interested in increasing health equity among refugee and immigrant groups as well as the well-being of ALL youth in U.S. communities.

Rubén Parra-Cardona, PhD, is an Associate Professor at the Steve Hicks School of Social Work at the University of Texas-Austin. He previously worked at Michigan State University, where he was an associate professor in the Department of Human Development and Family Studies, College of Social Science; and the associate director of the MSU Research Consortium on Gender-Based Violence. He was funded by NIMH to investigate the treatment efficacy and relevance of two versions of an evidence-based parenting intervention culturally adapted for Latino families with young children. He is currently funded by NIDA to extend this line of research to Latino families with adolescent children. He is the recipient of the 2013 American Family Therapy Academy Early Career Award for his innovative work on cultural adaptation research. He has a wealth of experience on research collaborations across the U.S.-Mexico border, and is currently vice-president of the Family Process Institute, a member of the board of directors of the Centro de Investigación Familiar (a leading family therapy institute in Mexico and in Latin America), and a clinical faculty member and researcher in the Instituto Regional de Estudios de la Familia (a leading family therapy institute in northern Mexico).

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Break2:15 - 2:20 pm

Take a quick 5 minute break or spend time connecting with your peers in chat!

image  "Ignite" Mini-Session A2:20 - 2:35 pm

Navigating the MIST: Identifying and Responding to Identity-Based Threats in the Air

Presenters: Jeffrey P. Winer, PhD and Luna Mulder, PsyD

Session Description:

This mini-session presented by Drs. Jeffrey P. Winer and Luna Mulder of the Refugee Trauma and Resilience Center at Boston Children’s Hospital/Harvard Medical School introduces the psychological framework of MIST (microaggressions, implicit bias, stereotype threat, and targeted identities) as a modular tool to support trauma-informed, cultural-responsive, and identity-affirming intervention and education (described briefly in Winer et al., 2018). MIST is a framework that can help providers and patients broach topics such as discrimination, stigma, and their impact of mental health, by identifying and unpacking four common ‘threats in the air’ that are pervasive and at times, traumatizing.

The 10 minute recorded segment will be divided into 3 sections:

  1. Discussion of identity contingencies (based in learning theory) and the distinction between threats on the ground and threats in the air. These social and cultural identity contingencies provide either ‘reinforcement’ (e.g., increase certain behaviors) or ‘punishment’ (e.g., decrease certain behaviors). Using Steele’s (2010) framework, there are two types of identity contingent threats – (1) ‘threats on the ground’ that directly block our engagement with aspects of living because of our identity (e.g., segregated spaces, visual symbols or icons of hate) and (2) ‘threats in the air’ which are more subtle social and psychological processes that we passively ‘breathe in’ (see Steele, 1997; 2010).  
  2. Introduction and exploration of the four phenomena outlined in the MIST framework - Microaggressions, Implicit bias, Stereotype threat, and Targeted identities. Microaggressions are the everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, which communicate hostile, derogatory, or negative messages to targeted persons based solely upon their marginalized group membership (e.g., Sue, 2007). Implicit bias is the unconscious attribution of particular qualities to a member of a certain social group. Implicit stereotypes are influenced by experience, and are based on learned associations between various qualities and social, ethnic, and cultural categories (e.g., Banaji & Greenwald, 2013). Stereotype threat is a situational predicament (e.g., context dependent as opposed to trait specific) in which people are or feel themselves to be at risk of conforming to stereotypes (i.e., historical and culture bound assumptions) about their social or cultural group (e.g., Steele, 2010). Targeted identities are social and cultural identities with historically less power and less access in their given context. ‘Dominant identities’ are identities with historically more power and access in their given context (e.g., Hays, 2016).
  3. Linking the MIST framework to trauma-informed and culturally-responsive strategies for the purpose of reducing identity-based stress and enhancing resilience and identity integration.
    Both presenters are clinical psychologists occupying diverse social and cultural identities and will speak to the unique value of humbly incorporating one’s own social and cultural identities into trauma-informed, culturally-responsive, and identity-affirming care.

Attendees will be provided with an electronic worksheet with all information to assist in learning and potential use/dissemination. The electronic worksheet will help support efficient use of the 5-minute question and answer period.

Presenters' Information:
Jeffrey P. Winer, PhD, is an Attending Psychologist at the Refugee Trauma and Resilience Center at Boston Children's Hospital and an Instructor of Psychology in the Department of Psychiatry at Harvard Medical School. Dr. Winer’s work is primarily focused on innovating, testing, and disseminating culturally-responsive psychological interventions for stress-related psychological problems experienced by youth and families of refugee and immigrant backgrounds. Dr. Winer received his undergraduate degree in Psychology and Philosophy Integrated Studies from Grinnell College and his MS and PhD in Clinical Psychology from the University of Massachusetts Amherst. He completed his clinical internship at McLean Hospital/Harvard Medical School and his postdoctoral fellowship at Boston Children's Hospital/Harvard Medical School. For more information visit www.drjeffwiner.com.

Dr. Luna Acharya Mulder currently works as a psychologist at the Refugee Trauma and Resilience Center at Boston Children’s Hospital. She has many years of experience providing clinical services to children and families and conducting psychological assessments to children suffering from mental illness. Dr. Mulder is Bhutanese and, in addition to training and experience in working with traumatized children, brings intimate knowledge of Bhutanese culture, language, and the refugee experience. She does trainings and consults to sites in Ohio and Canada on how to implement Trauma Systems Therapy for Refugees (TST-R) with refugee populations.

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Exhibition Hall 2:35 - 3:35 pm

Exhibition Hall

Please utilize this hour to visit our New Grantee Exhibition Hall where you will be able to learn about their projects and engage in live chat with representatives.

image  "Ignite" Mini-Session B3:35 - 3:50 pm

From Dogman to Jackie Robinson: Engaging Hard-to-reach Children & Parents with the Heroes Quest

Presenter: Richard Kagan, PhD

Session Description:

Enhance the power of a wide range of trauma treatment models by adding tools and strategies utilizing stories of heroes from children’s families and their cultural heritage. The ‘heroes quest’ delineated by Joseph Campbell provides a template for summoning courage and resources within families to work with therapists to change their lives after experiencing traumatic stress. Tools and activities evoking heroes can be used to identify a child’s developmental level and strengths that can be tapped to promote the safety, skills and relationships needed for phase-based trauma treatment. Strategies for using heroes will be demonstrated to rekindle hope, re-connect children and caring adults, promote self and co-regulation, and desensitize traumatic stress reactions.

Engaging and sustaining engagement of children and parents are often cited as the greatest challenges in trauma treatment especially with children referred to child welfare, juvenile justice and behavioral health care programs who have experienced multiple traumas and the break-down of primary attachments. Children, parents and other caregivers can be engaged with activities that elicit memories of important people in their lives and in the life stories of their families. Evoking stories of family members is especially useful to engage hard-to-reach and traumatized caregivers. Stories of people who have inspired family members can be used as models of rebuilding strengths and pride that can help counter feelings of shame or helplessness. Learning about real heroes in family’s lives can also help to overcome myths about solo heroes that can lead children, parents, and therapists to become isolated and overwhelmed. This mini-session will highlight application of tools from Real Life Heroes (RLH) with other evidence-supported trauma treatment programs. RLH is a resiliency-focused treatment for Complex Trauma that has been used successfully to engage hard-to-reach children and caregivers in a wide range of treatment programs including home-based family treatment, behavioral health clinics, foster care, kinship care, adoption, school-based programs, psychiatric hospitals, and residential treatment programs.  RLH was designed to be used with other evidence-supported treatment models and the Real Life Heroes Life Storybook, 3rd ed.  (Routledge, 2017) and the Real Life Heroes Toolkit for Treating Traumatic Stress in Children and Families, 2nd ed. (Routledge, 2017) help therapists to implement NCTSN-recommended ‘best practice’ treatments components for Complex Trauma and Child Welfare. Resiliency-focused strategies and activities promote engagement and ‘Relational Healing for Relational Traumas’ using creative arts, e.g. drawing, rhythm, tonality, yoga, mindfulness, ‘improv,’ and becoming the director of your own movie.

Participants in the mini-session will learn how to:  (1.) Access tools they can use to promote safety and strengthen or build relationships including SOS for Stress (adapted from Ford & Russo, 2006) and Circles of Caring (adapted from Antonucci, 1986), (2.) Utilize children’s and caregivers’ heroes to identify developmental levels, strengths, and challenges and model skill-building, and (3.) Utilize principles from Campbell’s ‘heroes quest’ to engage children and caregivers to share stories of overcoming adversity, become the directors of their own life movies, and work together to become stronger than the nightmares of the past.

Presenter's Information:

Dr. Kagan has had extensive leadership experience in non-profit child and family services and behavioral health care as director of professional development, QI, research, and psychological services and has served as the principal investigator for two SAMHSA-funded National Child Traumatic Stress Network (NCTSN) grants. Dr. Kagan has also served on the NCTSN Steering Committee, the Affiliate Advisory Board, the  Complex Trauma and Child Welfare Committees, the Trauma-Informed Organizational Assessment Advisory Group and co-led development of the NCTSN curriculum, Caring for Children Who Have Experienced Traumatic Stress as co-chair of the Resource Parent Committee. Before moving to Columbia, SC, he was the Director of Research and Consultation for the Sidney Albert Training and Research Institute at Parsons Child and Family Center in Albany, New York, a NCTSN community services site since 2002.
Dr. Kagan is the author or co-author of 34 articles, chapters, and papers and ten books: Families in Perpetual Crisis with Shirley Schlosberg (Norton), Turmoil to Turning Points; Building Hope for Children in Crisis Placements (Norton), Wounded Angels; Lessons from Children in Crisis (Child & Family Press); Rebuilding Attachments with Traumatized Children (Routledge); Healing from Losses, Violence, Abuse, and Neglect (Routledge), the Real Life Heroes Life Storybook 1st, 2nd and 3rd editions (Routledge), the Real Life Heroes Practitioner’s Manual (Routledge), the Real Life Heroes Toolkit for Treating Traumatic Stress in Children and Families (Routledge), and Wounded Angels; Inspiration from Children in Crisis (Routledge). Dr. Kagan’s presentations, articles, and books highlight practical and innovative approaches that practitioners and organizations can utilize to engage hard-to-reach children and parents/caregivers, to strengthen resilience and to reduce traumatic stress. Further information about Dr. Kagan’s publications and training programs can be found at www.reallifeheroes.net or by contacting Dr. Kagan at: richardkagan7@gmail.com.


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Break3:50 - 3:55 pm

Take a quick 5 minute break or spend time connecting with your peers in chat!

Workshop #23:55 - 4:55 pm

Macro and Micro Level Strategies for Creating a Culturally Responsive Workforce

Presenters and Contributors: 

Saida Abdi, LICSW, MSW, MA, PhD; Emma Cardeli, PhD; Alisa Miller, PhD; Carmen Rosa Noroña, LCSW, MS. Ed; Nicole St. Jean, PsyD; Savina Treves, MA, LPC

Session Information:

Interpreters and cultural brokers are important, highly valued members of the healthcare workforce. They serve as a bridge to help non- or limited English speaking clients access resources and healthcare services. Youth and families come to the U.S. for numerous reasons spanning/ranging from  seeking new and better social, political, economic, educational opportunities not available to them in their home countries; to fleeing from violence, war, torture, and deprivation of resources (like food, water, shelter, medical care). Having endured unforgiving traumas prior, during or after their immigration and /or resettlement journey, youth and families face complex cultural differences, uncertainty about the present and future such as safety, employment, legal status, as well as uncertainty around how to navigate systems for resources when settling in the U.S. Not speaking the English language or having familiarity of how to seek support or engage with healthcare systems can keep these families in places of isolation.  Incorporating interpreters and cultural brokers into the workforce can lead to improved patient engagement and treatment adherence in addition to optimizing health outcomes. However, agency administrators are often unsure of how best to create an infrastructure that is conducive to cross-cultural collaboration, inclusion, and encourage community-practitioner/community-academic partnerships. In addition, clinicians also report feeling ill-equipped or under-trained to work with international populations and/or interpreters and/or cultural brokers in therapeutic services. Complementarily it is important that interpreters and cultural brokers feel equipped and fully capable of understanding the mental health system and comfortable and supported to respond to the experiences of youth and families presenting for services. In this workshop, we will introduce audience members to the benefits of including interpreters and cultural brokers in their clinical teams and will provide clear organizational strategies for creating an infrastructure that can identify, train, support, and maintain a culturally responsive and diversity-informed workforce.   We will highlight key principles of a forthcoming NCTSN product entitled, “A Socio-Culturally, Linguistically- Responsive, and Trauma-Informed Approach to Mental Health Interpretation” that is designed to prepare mental health interpreters and clinicians to partner together in order to be able to provide increased access to trauma-informed services.

Presenters' Information:

Saida Abdi, LICSW, MSW, MA, PhD is the  Associated Director For Community Relations at the Boston Children’s Hospital Refugee Trauma and Resilience Center T(RTRC Cat II of the NCTSN). Ms. Abdi is a member of leadership team that has developed a model (Trauma Systems Therapy for Refugees) that has proven successful in engaging refugee communities using CBPR.  As the Associate Director for Community Relations, she has led RTRC’s efforts to build community partnerships and to increase mental health knowledge and services in diverse refugee communities. Her clinical practice focuses on supporting children and families impacted by violence and migration and her research focuses on factors related to resilience among refugee and immigrant children and families and the use of CBPR to promote community engagement and collaboration.

Emma Cardeli, PhD is a Research Associate at Boston Children’s Hospital Refugee Trauma and Resilience Center (RTRC Cat II of the NCSTN), an Instructor in Psychology at Harvard Medical School, and a licensed clinical psychologist who has many years of experience working with traumatized children, adolescents, and adults utilizing a wide range of trauma-informed treatment modalities across multiple settings.  Dr. Cardeli provides training and clinical consultation to various agencies across North America that are interested in integrating Trauma Systems Therapy for Refugees (TST-R) into their clinical service models.  She is also currently leading a multi-site program evaluation effort in order to build a stronger evidence base for the model.  Finally, Dr. Cardeli is Principal Investigator of an integrated care project in Jordan focused on investigating the mental health and psychosocial support needs of war-wounded, Syrian refugee youth in order to inform future intervention development.  Her research interests include distilling effective methodologies for the provision of culturally-responsive, trauma-informed care and for translating basic research for use by communities.  

Alisa B. Miller, PhD, is a Research Associate at Boston Children’s Hospital Refugee Trauma and Resilience Center (RTRC Cat II of the NCTSN) and a Licensed Clinical Psychologist in Massachusetts. Dr. Miller is an Assistant in Psychology in the Department of Psychiatry at Boston Children’s Hospital and an Instructor in Psychology at Harvard Medical School. At the RTRC, she conducts community-based participatory research and assists in intervention development. She has been an integral part of the team developing Trauma Systems Therapy for Refugees (TST-R) and provides training and consultation to various agencies across the United States implementing this model. Her interests focus on how trauma, migration, and culture shape development and impact life trajectories. Dr. Miller is interested in increasing health equity among refugee and immigrant groups as well as the well-being of ALL youth in U.S. communities.

Carmen Rosa Noroña, LCSW, MS. Ed., CEIS is from Ecuador where she trained and practiced as a clinical psychologist. In the Unites States she obtained master degrees in social work and in early intervention. For over 25 years, Carmen Rosa has provided clinical services to young children and their families in a variety of settings including early intervention, home-based and outpatient programs. She currently is the Child Trauma Clinical Services and Training Lead at Child Witness to Violence Project and is the Associate Director of the Boston Site Early Trauma Treatment Network at Boston Medical Center. She is a Child-Parent Psychotherapy National Trainer, a DC: 0-5 faculty and one of the developers of the Harris Professional Development Network Diversity Informed Tenets for Work with Infants Children and Families Initiative. Her practice and research interests are on the impact of trauma on attachment; the intersection of culture, immigration, and trauma; diversity-informed reflective supervision and consultation; and on the implementation and sustainability of evidence-based practice in real world settings. She is a former co-chair of the Culture Consortium of the National Child Traumatic Stress Network, and has adapted and translated materials for Spanish-speaking families affected by trauma. Carmen Rosa has also contributed to the literature in infant and early childhood mental health and diversity.

Nicole St. Jean, PsyD  is a Licensed Clinical Psychologist and Research Associate at Northwestern University Feinberg School of Medicine. At Northwestern she serves as the Clinical Director for the Center for Child Trauma Assessment, Services, and Interventions (CCTASI Category II of the NCSTN) where she provides clinical oversight and leadership to the Center’s activities in the areas of Child Welfare, Juvenile Justice, and culturally responsive practices. Dr. St. Jean is also the Director of the Kovler Child Trauma Center (a Category III NCTSN Center), which provides therapeutic and social support services to immigrant and refugee youth and families who have experienced trauma as a result of war, torture, forced migration, family separation, and/or resettlement. She has specialized in providing on trauma-informed therapeutic services and developing and delivering training and resources to support youth and families who have experienced complex trauma, the majority of whom are from historically underserved and oppressed communities.

Savina Treves, MA, LPC. Ms Treves’ earned a BA in Psychology from the University of Puerto Rico and an MA in International Disaster Psychology from the University of Denver. Ms Treves has intensive experience in providing evidence based trauma treatment through a three year Safe Start grant project in which she was the lead therapist and supervisor for TF-CBT implementation. In addition to experience as a school based therapist in Aurora Public Schools, Ms. Treves is currently the Trauma Resilience Youth Program Director. The Trauma Resilience Youth program (TRYP) is funded as a Category III NCTSN grant and provides culturally informed and evidenced-based trauma treatment with the goal of increasing access to mental health services for first and second generation refugee and immigrant children.

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